Darren Carr, CEO Hawkesbury Hills Division of General Practice
 An important approach to conserving water is to provide dual water supplies (dual reticulation) to new housing developments. The Rouse Hill Recycled Water Scheme is Australia’s largest such development, with 18 000 homes in North-Western Sydney having non-potable (non-drinking) water derived from recycled sewage effluent for some purposes such as toilet flushing and outdoor use in addition to a conventional water supply. Whilst adverse health effects are considered very unlikely no studies have been undertaken either in Australia or internationally to assess the impact of non-potable recycled water exposure on the health of the general public in this context.
A partnership between Hawkesbury-Hills Division of General Practice, Monash University and the Cooperative Research Centre (CRC) for Water Quality and Treatment investigated rates of General Practitioner consultations for acute gastroenteritis, respiratory infections and skin complaints – all plausibly related to recycled water exposure. Presentation rates amongst residents living in the dual water reticulation area were compared to rates for the same health complaints amongst residents of nearby areas receiving only conventional water supplies. 35 828 patient records covering the years 2005-2006 across 11 General Practices were examined.
Innovative and collaborative approaches between Divisions of General Practice and health researchers are required to measure small effects on community health that would not otherwise be detected by established surveillance mechanisms. These health impacts are of great interest to local communities, health care professionals and other stakeholders.
Undertaking this research posed many challenges – cultural differences between private General Practice and Research Institutions, ethics approval where individual patient consent was not feasible and the mixed quality of medical records found across (and sometimes within) different general practices.
Working together, however, an effective partnership between Hawkesbury-Hills Division of General Practice and Monash University enabled this important and topical issue to be accurately investigated. Implementing research with the Division of General Practice and not just through it was the key factor to ensuring a successful research project. To do this Research Institutions should partner carefully, working with Divisions that have a strong commitment to full partnership research, and involve them from prior to the inception of any research project. Divisions should develop a position on research that adds value for the community and practices they serve.
Our findings – there was no difference in General Practice presentation rates between patients living in the recycled and conventional water supply areas for any of the health conditions investigated.
Divisions of General Practice and Research Institutions should partner together to investigate important health issues in the primary care sector. Doing so can result in significant advancements to our knowledge about important health issues.
Author Bio
Darren Carr has worked in the health industry for twenty years in a number of roles. His first seven years were as a Radiation Therapist before moving on to the NSW Cancer Council as a Community Development Officer then Regional Program Co-ordinator. For the past eight years he has been CEO of Hawkesbury-Hills Division of General Practice. Darren holds Masters Degrees in Health Science Education and Public Health (with Honours) from the University of Sydney. Darren is a passionate advocate for health system reform that sees multi-disciplinary primary care as the central plank of Australia’s health system.
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